Findings from an innovative peer support, outreach- and harm reduction-based pregnancy program for street-involved women

Pages from SROI HER Summary FINAL 2014

The Healthy, Empowered and Resilient (H.E.R.) Pregnancy Program uses professional staff and peer support workers to reach at-risk pregnant and parenting women in inner city Edmonton. The program, developed by Streetworks, supports street-involved women to access healthcare services before and throughout their pregnancy and address issues such as addiction, poverty and family violence.

The H.E.R. Pregnancy Program staff team is comprised of three pregnancy support workers who have street knowledge and experience as well as a registered nurse and social worker. It is primarily located within Boyle Street Community Services in Edmonton, Alberta.

Findings from a three-year evaluation of the program have recently been released. The evaluation included a photovoice project with clients, staff focus groups, key informant interviews with stakeholders, an analysis of program data, and a Social Return on Investment (SROI) analysis.

The findings of the study show a number of successes. Overall, the program is helping women to keep their babies and become parents. Women are being supported in accessing previously out-of-reach health and social resources and services (i.e., medical services, housing, and income assistance) and are experiencing a number of positive changes related to substance use and sexual practices. The evaluation findings also suggest that many women are feeling more empowered to stay safe and be involved in decisions about the care of their babies. Using highly conservative estimates of the number of clients impacted, the Social Return on Investment analysis suggests that every dollar invested in the program yields a return of $8.24 in social value.

Here’s a quick summary of some of the findings:

Who did the program serve?

  • 130 street involved pregnant women & 117 non-pregnant women received services/support from H.E.R. Pregnancy Program
  • 55% of pregnant women were between the ages of 20 and 29 and 83% were of First Nations, Inuit, or Metis ancestry
  • 63% of women had experienced previous pregnancies
  • 60 women gave birth, with H.E.R. staff attending 22% (or 13) of these births
  • On average, pregnant women visited the program 29 times from preconception through to the baby’s due date

Reducing or Stopping Substance Use

  • 76% of the 139 pregnant women reported substance use, typically alcohol (32%), marijuana, and other drugs
  • While connected with the program, women reported elimination of use (40%), safer use (37%), and reduction of substance use (26%) at least once during their pregnancy with the program

Improving Housing Outcomes

  • 22% of 78 pregnant clients who were homeless or unstably housed at program start moved into housing while with the program

Supporting Women in Keeping Custody of their Babies

  • Of 60 births, 53% (or 32) remained in the care of their mothers and 5 (8%) went into the care of family or friends.
  • 19 (32%) of births resulted in the baby being placed in care. For 2 (3%) of births, the babies were adopted
  • Children’s Services was involved in 30 of 60 (50%) of births. In 21 (70%) of births where Children’s Services was involved, women had a role in child placement decisions.
  • Many women who were unable to parent because of homelessness or other factors were able to explore alternative options for staying connected with their babies

For more on the H.E.R. Pregnancy Program, see earlier posts:

References

Charis Management Consulting Inc. (2013). Impact Evaluation of the H.E.R. Pregnancy Program – Program Data Report. Prepared by Charis Management Consulting Inc. for the Alberta Centre for Child, Family and Community Research.

Nathoo, T., Poole, N., Bryans, M., Dechief, L., Hardeman, S., Marcellus, L., Poag, E., Taylor, M. Voices from the community: Developing effective community programs to support pregnant and early parenting women who use alcohol and other substances. First Peoples Child & Family Review, 8(1):  93-106. (Free full-text here)

Wodinski, L., Wanke, M.I. and Khan, F. (2013). Impact Evaluation of the H.E.R. Pregnancy Program – Final Summary Report. Prepared by Charis Management Consulting for the Alberta Centre for Child, Family and Community Research.

Wodinski L & Wanke M I. (2013). Impact evaluation of the H.E.R. Pregnancy Program – Photovoice Final Report. Prepared by Charis Management Consulting Inc. (Charis) for the Alberta Centre for Child, Family and Community Research.